The evidence is clear: abortion contributes to mental health problems, at least for some women. For example, a 2016 analysis of data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) has shown that each exposure to abortion increases the risk of mental disorders by 23 percent, even after controlling for 25 other factors, including prior mental health issues.
A 2023 study also indicates that pressure to undergo an abortion is associated with poorer mental and emotional outcomes. The American Psychological Association (APA) has acknowledged that these and other risk factors – including lack of support from others, feelings of stigma, pre-existing mental or emotional problems, wanting to keep the pregnancy, and repeat abortion – are associated with more mental health problems following an abortion.
These findings have been confirmed by a recent peer-reviewed CLI analysis of state Medicaid data showing that, compared to women who give birth, women who have an abortion in their first pregnancy are 3.4 times more likely to experience an increase in outpatient mental health visits and 5.7 times more likely to experience an increase in inpatient admissions. Similarly, another peer-reviewed CLI study of Medicaid data demonstrates that women with a history of pregnancy loss, including abortion, are approximately 35 percent more likely to require post-partum mental health treatment following their subsequent first live birth.
Substance abuse
- A 2011 meta-analysis shows that, compared to women without abortions, women who have abortions are over three times as likely to use marijuana and more than twice as likely to use/misuse alcohol.
- The Add Health study shows that women who have abortions are twice as likely to abuse alcohol, 2.5 times as likely to misuse marijuana, and over three times as likely to use illicit drugs.
Depression/anxiety
- According to the 2011 meta-analysis, women who have abortions are 37 percent more likely to suffer from depression and 34 percent more likely to have anxiety, compared to women without abortions.
- This is backed up by data from Add Health showing that women who have abortions are 30 percent more likely to experience depression and 23 percent more likely to have anxiety.
Suicide and violent death
Studies of women in the United States, Italy, and Finland show that women who have abortions have approximately two to six times the risk of suicide within a year compared to women who give birth. This risk increases with multiple abortions. Additionally, women who undergo abortion have a significantly higher rate of death from violent causes. Together with an elevated risk of death from other stress-related illnesses, national record linkage studies demonstrate that each abortion increases the risk of premature death by 50 percent.
Unwanted abortions
Of special concern is the harm abortion does to women who feel pressured into abortions, the focus of CLI’s peer-reviewed Unwanted Abortions Studies. In one study, our national survey of 1,000 women found that over 60 percent of those who had abortions reported high levels of pressure to abort. Most reported a desire to have given birth if they had received more support from others. Sixty-seven percent described their abortions as either inconsistent with their own values or preferences (43 percent), unwanted (14 percent), or even coerced (10 percent). As predicted by the APA, women who felt pressured blamed their abortions for causing more mental health problems, feelings of loss or grief, and disruptions of their relationships and daily life.
There is no evidence that abortion ever improves women’s mental health.
In a 2013 literature review and meta-analysis, the prominent and self-identified pro-choice researcher David Fergusson concluded, “There is no available evidence to suggest that abortion has therapeutic effects in reducing the mental health risks of unwanted or unintended pregnancy.”
Notably, one well-known survey of a small cohort of women who sought abortions beyond legal gestational age limits, and were therefore turned away (the “Turnaway Study”), did report that women who were unable to get abortions had slightly more anxiety and lower self-esteem one week later. However, this difference was greatest for women who were still seeking abortions, and the differences diminished over time. Despite the significant biases in and limitations of the study, including a high drop-out rate, no other mental health differences were identified over the five-year study period. The results also showed that women who obtained abortions reported high rates of regret, guilt, sadness, and PTSD.
There is no evidence to suggest that abortion ever directly benefits women’s mental health. In contrast, nearly every study has found that abortion is linked to more mental health problems in women, especially those who have one or more of the known risk factors. While nearly all psychological conditions are multifactorial, abortion can be a contributing factor in mental illness for some women, and numerous studies controlling for prior mental health issues have indicated that abortion is an independent risk factor for more mental health problems.
